Page (PDF) | 15 |
---|---|
Certificate Number | 2079 |
Name of Deceased | Collins, Jake |
Place of Death | Worcester |
Town of Death | Stockton |
Sex | M |
Race | colored |
Married, Widowed, or Single | married |
Date of Birth | unknown |
Age (year, month, days) | abt 54 yrs |
Occupation or Employer | laboror; farm work |
Birthplace | Maryland |
Father's Name | unknown |
Father's Birthplace | unknown |
Mother's Name | Grace Wise |
Mother's Birthplace | Maryland |
Informant (Relationship and Address) | Edward Justice; Stockton Md |
Date of Death | 2/2/1922 |
Cause of Death and Time Attended by Doctor | no physician attenden. Been sick abt 1 yrs. Tuberculosis was cause |
Immediate, Secondary, or Contributory Cause and How Long | – |
Physician and Address | WO Rayne; Stockton Md |
Burial Place, Date, Undertaker, and Address | Old St Paul Cem; 2/4/1922; FA Cal Singlton?; New Church Va |
Length of Residence, Where Disease Contracted, Former Residence | – |
Other Notes | – |
If you are citing this record, please use the following format:
[Author (if known)]
, Maryland Death Certificates (Somerset, Wicomico, Worcester Counties), 1910-1922, [Date (if known)]
, Enduring Connections: Exploring Delmarva’s Black History, Nabb Research Center, Salisbury University.
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